Growing pains in children – symptoms, diagnosis and management

Five-year old Nicky woke up at 1 am screaming with pain in the legs. His parents soothed him and massaged his legs, and within half an hour the pain resolved and Nicky fell asleep. Next morning, Nicky went about his activities as though nothing happened in the night. Parents were relieved. The pain was back, however, after a week or so. Next morning, the anxious parents took him to a doctor. Fortunately, for Nicky, the pain was diagnosed as ‘growing pains’. Many parents believe that growing pains occur when the child is growing rapidly, that is, during the rapid growth period between birth and two years of age, and then during adolescence. However, growing pains have actually nothing to do with growing up! Medically, it is termed benign idiopathic nocturnal limb pains of childhood, which, generally, affects children aged 3 to 12 years.[1] Symptoms There are no definite symptoms except for muscular pains in front of the thighs, in the calves, or behind the knees. Pains occur commonly during nights.The pains may be intense for some children, while milder for others. Growing pains do not occur every day. The pain does not limit or affect the child’s activities. Researchers found that frequency of pain episodes gradually declines over 1 to 2 years and, in most cases, pain goes away completely as the child reaches adolescence. [2] Take your child to the doctor if s/he experiences – Pain in just one leg Pain every night Pain in arms or back Pain associated with an injury Swelling in the joints Weight loss Loss of appetite Fatigue, tiredness You may also need to take the child to see the doctor if s/he is reluctant to walk or limps, especially in the morning. If the physical examination is ‘normal’, your child most probably is experiencing growing pains. However, if there are other symptoms apart from the pain, it may be due to other medical conditions. Differential diagnosis Medical conditions that can have intense pain as one of the symptoms include: Injury related leg pain: This is easily diagnosed. Pain is usually localized. However, it may not be that obvious in cases of non-accidental trauma, or battered child syndrome. Try to be more specific when explaining this to the doctor. Osgood-Schlatter disease and Runner’s knee: Osgood-Schlatter disease is an inflammatory disease characterised by a painful bump just below the knee where the tendon from the kneecap attaches to the tibia (shin bone). This condition is more commonly found in adolescent boy athletes. Similarly, Runner’s knee commonly affects girl athletes (runners). Juvenile Idiopathic Arthritis (JIA): This type of arthritis is difficult to diagnose, but it is different from growing pains because of the symptoms such as persistent swelling and joint pain, fever, and rash. The main difference between JIA and growing pains is the persistent nature of pain and morning symptoms. [3] Infections: Infections are usually accompanied by fever and toxicity. Swelling, redness, and tenderness at the site of pain are other symptoms of infections. Benign […]

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